Nutritional Environment in Primary & Secondary Schools

Rebecca NowachekWalden University

In partial fulfillment of the requirements for PH 6165-5Rebecca HeickJuly 19, 2009

Purpose To inform stakeholders on how the school

environment can have a major impact on the childhood obesity epidemic.

Objectives To understand the criteria used to determine if a child

or adolescent is overweight or obese. To understand the childhood obesity problem facing

families and communities. To understand why primary and secondary schools

have an important role in reducing childhood obesity. To learn ways to change the nutritional environment

for students. To learn the importance of added educational topics

on nutrition for students.

Background Overweight vs. Obesity Determination of weight status Cause of Obesity Consequences Obesity in the United States Obesity in Iowa

Overweight vs. Obesity Overweight= BMI at or above 85th percentile and

lower than 95th percentile. Obese= BMI is at or above the 95th percentile

CDC. 2009. Overweight and obesity: Defining childhood overweight and obesity. Retrieved from July 11, 2009 from http://www.cdc.gov/obesity/childhood/defining.html

Cause of Obesity Imbalance between calories consumed and calories

used. Imbalance can be influenced by:

• Genetics• Behavioral• Environmental

CDC. 2009. Overweight and obesity: Contributing factors. Retrieved July 11, 2009 from http://www.cdc.gov/obesity/childhood/causes.html

Consequences of Obesity Psychological risks Cardiovascular disease

• High blood pressure• High cholesterol

Asthma Sleep apnea Type 2 diabetes

CDC. 2009. Consequences. Retrieved on July 11, 2009 from http://www.cdc.gov/obesity/childhood/consequences.html

Obesity in the United States Prevalence (NHANES) Impact

• About ½ of diabetes cases are type 2

• 61% of obese 5-10 year olds have risk factors for heart disease

• Obese children and adolescents more likely to be obese adult

Cost• direct and indirect

costs for 2002 were $92.6 billion

1976-1980

2003-2006

2-5 5.0% 12.4%

6-11 6.5% 17.0%

12-19 5.0% 17.6%

CDC. 2009. Childhood overweight and obesity. Retrieved July 11, 2009 from http://www.cdc.gov/obesity/childhood/index.html

American Heart Association. 2005. A Nation at Risk: Obesity in the United States. Retrieved July 13, 2009 from http://www.americanheart.org/downloadable/heart/1114880987205NationAtRisk.pdf

Institute of Medicine.2004.Childhood obesity in the United States: Facts and figures. Retrieved July 13, 2009 from http://www.iom.edu/Object.File/Master/22/606/FINALfactsandfigures2.pdf

Obesity in Iowa About 80,000 children 10-17 years of age in Iowa are

overweight or obese Overweight and obesity prevalence is almost double

in poor families compared to children in higher income families (39.6% to 21.4%).

NICH.(nd). Childhood obesity action network. Retrieved July10, 2009 from http://nschdata.org

“Every school day, 54 million young people attend nearly 123,000 schools across the

country. Influencing and enhancing the ability of schools to provide a healthy environment could be one of the most effective ways to shape the health, education, and well-being of our next

generation”– President Bill Clinton

Healthy Eating Podcast SHPPS – School Health Policies & Programs Study:

Healthy Eating Released September 9,2009

CDC. 2009. School health policies & program study: healthy eating. Retrieved July 12, 2009 from http://www2a.cdc.gov/podcasts/player.asp?f=10045

School Environment Status

0%

10%

20%

30%

40%

50%

60%

70%

80%

US Iowa

Students could purchasefruits & vegetables

Students could purchassoda & fruit drinks

Students could purchasechocolate candy

Did not allow students topurchase foods &beverages high in fat,sodium, or added sugarduring lunch periods

CDC. The obesity epidemic and Iowa students. Retrieved on July12, 2009 from www.cdc.gov/HealthyYouth/yrbs/pdf/obsesity/yrbs07_iowa_obesity.pdf

CDC. The obesity epidemic and United States students. Retrieved on July12, 2009 from www.cdc.gov/HealthyYouth/yrbs/pdf/obesity/yrbs07_us_obesity.pdf

18%

77%

50%

52%

28%

75%

47%

64%

Students & Nutrition Only 2% of youth meet all recommendations of food

guide pyramid < 15% of school children eat recommended fruit

servings <20% eat recommended vegetable servings <25% eat recommended servings of grains <30% consume recommended milk servings Teens drink 2 times more soda than milk 12% of students report skipping breakfast

United States Department of Agriculture. (nd). Healthy school nutrition environment: Promoting healthy eating behaviors. Retrieved July 14, 2009 from www.teamnutrition.usda.gov/healthy/call2act.pdf

Nutritional Standards in United States

19 states have nutritional standards for school lunches, breakfasts and snacks that are stricter than USDA requirements

27 states have nutritional standards for competitive foods sold a la carte, in vending machines, school stores, or school bake sales

25 states have passed requirements for BMI screenings

RWJ Foundation. (2009). New reports find obesity epidemic increase, Mississippi weighs in heaviest state. Retrieved on July11, 2009 from www.rwjf.org/childhodobesity/products.jsp?id=45348.

Implementation of Nutritional Educational Programs

99% of public schools offer some kind of nutritional education

Nutrition education showed accomplishment of 3 objectives:• Nutritional facts so students can make better

decisions about healthy eating• Change unhealthy attitudes• Teach positive skills

Home & School collaboration

Celebuski,C.,Farris,E.,Carpenter,J. 1996. Nutrition education in public elementary and secondary schools. Retrieved July16,2009 from http://nces.ed.gov/pubs/96852.pdf

Healthy Environment Doesn’t end at School Lunch programs

• Breakfast• Snacks• Vending machines• Concessions• School parties

Benefits of Healthy Environments

Encourages healthy eating Greater academic achievement Improved attendance Healthier lives Healthy growth & development Lowered risk of

• Dental caries• Eating disorders• Malnutrition• Iron deficiency

CDC.2008. Nutrition and the health of young people. Retrieved on July 16,2009 from www.cdc.gov/HealthyYouth/nutrition/Facts.htm

Outcomes To start a school wellness council. Assess school environment to identify areas of

improvement Develop an action plan Identify resources Take action to create a healthier school environment Celebrate your success

Additional Resources Changing Scene: Improving School Nutrition

Environment www.fns.usda.gov/TN/resources/changing.html

Making it Happen: School Nutrition Success Stories

www.cdc.gov/HealthyYouth/nutrition/Making-It-Happen/download.html

Nutrition Standards for Food in Schools: Leading the Way Toward Healthier youthwww.iom.edu/cms/3788/30181/42502.aspx

A Nation at Risk: Obesity in the United States. http://www.americanheart.org/downloadable/heart/1114880987205NationAtRisk.pdf

Additional Resources Team Nutrition / Fitness Guide: For K-12 Classrooms

http://www.impactchildhoodobesity.org/images/docs/K-12_Nutrition_Lesson_Plans.pdf

Conclusion

ReferencesAmerican Heart Association. 2005. A Nation at Risk: Obesity in the United States. Retrieved July 13,

2009 from http://www.americanheart.org/downloadable/heart/1114880987205NationAtRisk.pdfBlom-Hoffman,J.,Wilcox,K.,Dunn,L.,Leff,S.,& Power,T. 2008. Family involvement in school-based health

promotion: bringing nutrition information home. School Psychology Review, 37(4), 567-577. Retrieved July 16,2009 from Academic Search Premier Database.

CDC. 2009. Consequences. Retrieved on July 11, 2009 from http://www.cdc.gov/obesity/childhood/consequences.html

CDC. 2009. Overweight and obesity: Contributing factors. Retrieved July 11, 2009 from http://www.cdc.gov/obesity/childhood/causes.html

CDC. 2009. Overweight and obesity: Defining childhood overweight and obesity. Retrieved from July 11, 2009 from http://www.cdc.gov/obesity/childhood/defining.html

CDC. 2009. School health policies & program study: healthy eating. Retrieved July 12, 2009 from http://www2a.cdc.gov/podcasts/player.asp?f=10045

CDC. The obesity epidemic and Iowa students. Retrieved on July12, 2009 from www.cdc.gov/HealthyYouth/yrbs/pdf/obsesity/yrbs07_iowa_obesity.pdf

CDC. The obesity epidemic and United States students. Retrieved on July12, 2009 from www.cdc.gov/HealthyYouth/yrbs/pdf/obesity/yrbs07_us_obesity.pdf

CDC. 2009. Childhood overweight and obesity. Retrieved July 11, 2009 from http://www.cdc.gov/obesity/childhood/index.html

Celebuski,C.,Farris,E.,Carpenter,J. 1996. Nutrition education in public elementary and secondary schools. Retrieved July16,2009 from http://nces.ed.gov/pubs/96852.pdf

References (Cont.)Daniels,S.R., Arnett,D.K, Eckel,R.E., Gidding,S.S., Hayman,L.L., Humanyika,S.,Robinson,T.N., Scott,B.J.,

Jeor,S., Williams,C.L.2005. Overweight in children and adolescents: Pathophysiology, consequences, prevention, and treatment. Retrieved July 16, 2009 from http://circ.ahajournals.org/cgi/content/full/111/15/1999?ck=nck

Institute of Medicine.2004.Childhood obesity in the United States: Facts and figures. Retrieved July 13, 2009 from http://www.iom.edu/Object.File/Master/22/606/FINALfactsandfigures2.pdf

NICH.(nd). Childhood obesity action network. Retrieved July10, 2009 from http://nschdata.orgRWJ Foundation. (2009). New reports find obesity epidemic increase, Mississippi weighs in heaviest

state. Retrieved on July11, 2009 from www.rwjf.org/childhodobesity/products.jsp?id=45348.United States Department of Agriculture. (nd). Healthy school nutrition environment: Promoting

healthy eating behaviors. Retrieved July 14, 2009 from www.teamnutrition.usda.gov/healthy/call2act.pdf